Healthcare Provider Details

I. General information

NPI: 1336222322
Provider Name (Legal Business Name): JOSHUA GEOFFREY SUMMERS LIC. ACUP.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1112 BOYLSTON ST 3RD FLOOR
BOSTON MA
02215-3660
US

IV. Provider business mailing address

1200 COMMONWEALTH AVE APT. 2
ALLSTON MA
02134-4636
US

V. Phone/Fax

Practice location:
  • Phone: 781-710-5215
  • Fax:
Mailing address:
  • Phone: 781-710-5215
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number222892
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: